Q: I have prediabetes. How can I turn it around?
A: While there are several things that can increase your risk for type 2 diabetes, healthy lifestyle changes can cut your risk in half without medication. Read on to find out how.
What is prediabetes? Most cases of prediabetes are caused by insulin resistance. In other words, some things are blocking the insulin from working.
Insulin is a hormone that helps the body use glucose for energy. Glucose (a type of sugar) provides energy to the brain, to muscle, and to most of the cells that make up the body. Without enough glucose, the brain does not function as well, muscles tire easily during exercise, and we may have general feelings of low energy.
Insulin is often described as a key that opens the cells so the glucose can enter. Inside the cell, the glucose is turned into energy.
With insulin resistance, the keys are still there, but they don't work like they used to. So the cells do not open as quickly as they should. Locked out of the cells, glucose stays in the bloodstream longer and builds up, leading to higher blood sugar levels.
What causes insulin resistance? While age, genetics, ethnicity, some medications, stress, and other health conditions can contribute to insulin resistance, the biggest contributors to the increase in prediabetes are low physical activity, poor diet, and excessive weight gain.
How does physical activity help insulin resistance? During exercise, muscle uses more glucose for fuel. Like insulin, physical activity is another key that opens muscle cells to allow glucose to enter. Thus, it improves insulin resistance. The American Diabetes Association recommends moderate physical activity at least 30 minutes or more most days of the week.
If it has been a while since you've been regularly active, walking is considered a safe activity to get started for most people. For more intensive activities, consult with your physician prior to beginning a new exercise program.
The biggest challenge for most people is keeping up an exercise routine. Here are some ideas for staying motivated.
How does food affect insulin resistance? The following types of food affect insulin resistance in the following ways:
Diets high in saturated fat have been shown to worsen insulin resistance. The saturated fat directly blocks the insulin from working. Foods high in saturated fat include fast food, many restaurant foods, and meals made with large portions of high fat meat, processed meat, or full fat dairy like cheese, butter and cream. Think cheeseburgers, pizza, ice cream, sausage, cream or cheese sauces, and animal fat.
Carbs do not directly block insulin from working. However, large amounts of sweets and low-fiber carbs can cause insulin spikes. Insulin spikes can cause weight gain; weight gain can lead to insulin resistance. Learn more about how carbs really affect blood sugar.
Large portions of anything can lead to extra calories, which further causes weight gain.
How does weight affect insulin resistance? Weight is especially a concern when there is extra fat stored in the abdominal area, otherwise known as belly fat. The fat cells in the abdominal area release other hormones that work against insulin, thus worsening insulin resistance. A reduction in belly fat can help lower those competing hormones and allow insulin to do its job better.
For prediabetes, the CDC's National Diabetes Prevention Program (NDPP) recommends a weight loss of at least 5% within 6 months. Maintaining that weight loss for the long term can help prevent diabetes, and maybe even reverse prediabetes. The American Diabetes Association states that an eventual weight loss of 15% or more has even greater outcomes. In both cases, maintaining weight loss is key in preventing diabetes. Beware of yo-yo dieting, which can actually worsen your health in the long run. Instead of diving into a strict diet, start here.
So how can you prevent type 2 diabetes? A well-balanced lifestyle of healthy food choices, portion control, and physical activity can help you reach and maintain a healthier weight. Together, these factors can cut your risk for diabetes in half. The research behind the NDPP showed that lifestyle change alone can provide better results than medication treatment. If making long-term lifestyle changes has been difficult for you, consider finding a NDPP program near you. This year-long program can give you the support you need to make changes that last. If a year-long group program is not your thing, see a registered dietitian nutritionist for personalized support in making the changes that are right for you.
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